Follow-up of branch duct IPMN. Various clinical approaches

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  • ＩＰＭＮの治療方針　　分枝型ＩＰＭＮの経過観察法―その方法を中心として―
  • ―その方法を中心として―

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Description

IPMNs are less invasive than main duct IPMNs, and in many of the cases, they do not progress even over a long period of time. For this reason, treatment for branch duct IPMNs is either surgery or follow-up observation. The decision to resect or not is based on imaging findings such as the status of elevated mural nodules, and the diameters of the main pancreatic duct and dilated branch duct. According to the International Consensus Guidelines, the diameter of the dilated branch duct is the most important, followed by the presence of mural nodules and dilation of the main pancreatic duct, as indicators of malignancy. In Japan, on the other hand, the majority considers the height of mural nodules the most important, followed by dilation of the main pancreatic duct. Regarding decision for treatment or follow-up, evaluations of both the pancreatic duct and elevation of mural nodules are necessary ; for the former, US, CT and MRCP should be used, and for the latter, EUS is indispensable. It is noted recently that IPMN is often accompanied by common type pancreatic cancer. For this reason, it is essential to examine the entire pancreas at follow-up visits. Furthermore, regular whole-body examination is also important since distant metastases are frequent in IPMN patients.

Journal

  • Suizo

    Suizo 20 (6), 522-531, 2005

    Japan Pancreas Society

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